Taweerutchana Voraboot, Choksakunwong Sawaraj, Lerwattrakarn Amornrat, Chalermwai Wipapat Vicki, Intralawan Thita, Lertwattanarak Raweewan
Minimally Invasive Surgery Unit, Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Heliyon. 2024 Jul 6;10(14):e34239. doi: 10.1016/j.heliyon.2024.e34239. eCollection 2024 Jul 30.
Insulinoma during pregnancy is a rare condition with vague clinical symptoms, making diagnosis challenging. The standard treatment for insulinoma is surgical tumor removal, preferably using a minimally invasive method. However, there have been no recorded examples of employing a robotic platform in pregnant women with insulinoma. In this report, we present the first successful case of robotic enucleation for insulinoma during pregnancy.
A 30-year-old pregnant woman presented with recurrent hypoglycemic symptoms throughout her first trimester that were relieved by food intake. After confirming endogenous hyperinsulinemia, an abdominal magnetic resonance imaging scan was performed to locate the tumor. A well-defined 2-cm mass was found in the pancreatic body. Robotic enucleation was performed at week 18 of gestation, and the patient experienced relief from hypoglycemic episodes postoperatively. Her blood glucose levels returned to normal, and she had an uneventful pregnancy. The patient eventually delivered a healthy baby via cesarean section without any complications.
For a subset of pregnant individuals with insulinoma, a minimally invasive approach as robotic-assisted surgery is safe and feasible. This innovative technique has the potential to both mothers and fetuses.
妊娠期胰岛素瘤是一种临床症状不明确的罕见疾病，诊断具有挑战性。胰岛素瘤的标准治疗方法是手术切除肿瘤，最好采用微创方法。然而，尚无在妊娠期胰岛素瘤患者中使用机器人平台的记录实例。在本报告中，我们展示了首例妊娠期胰岛素瘤机器人摘除术成功病例。
一名30岁孕妇在孕早期出现反复低血糖症状，进食后缓解。在确认内源性高胰岛素血症后，进行了腹部磁共振成像扫描以定位肿瘤。在胰体部发现一个边界清晰的2厘米肿块。在妊娠第18周进行了机器人摘除术，患者术后低血糖发作症状缓解。她的血糖水平恢复正常，孕期顺利。患者最终通过剖宫产分娩出一名健康婴儿，无任何并发症。
对于一部分患有胰岛素瘤的孕妇，机器人辅助手术这种微创方法是安全可行的。这种创新技术对母亲和胎儿都有潜在益处。
